Jerry Russell Hill, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4704093472 Issued in MI

Practice address

205 Osceola St
Laurium, MI 49913-2134

Phone

(906) 337-6500

Fax

(906) 523-6129

NPI assigned

Aug 10, 2005

Last updated

Jun 3, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Portage Hospital LLC

  dba UP Health System Portage

  • General Acute Care Hospital
  • Hancock, MI
  • NPI 1245667229
  Medicare reassignment NPD
• Saginaw Anesthesia Services, PLLC

  • Anesthesiology Physician
  • Saginaw, MI
  • NPI 1205083615
  Medicare reassignment NPD
• Aspirus Keweenaw

  dba Aspirus Laurium Clinic

  • Rural Health Clinic/Center
  • Laurium, MI
  • NPI 1205998713
  NPD
• Portage Hospital LLC

  dba UP Health System Portage

  • Durable Medical Equipment & Medical Supplies
  • Hancock, MI
  • NPI 1710314547
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1821099060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24559 S KLINGVILLE RD",
            "city": "CHASSELL",
            "state": "MI",
            "postal_code": "499169265",
            "telephone_number": "906-523-6129",
            "fax_number": "906-523-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 OSCEOLA ST",
            "city": "LAURIUM",
            "state": "MI",
            "postal_code": "499132134",
            "telephone_number": "906-337-6500",
            "fax_number": "906-523-6129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILL",
        "first_name": "JERRY",
        "middle_name": "RUSSELL",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ME",
            "license": "RNA203021",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704093472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "RN76197",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN LICENSE",
            "identifier": "4704093472",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA LICENSE",
            "identifier": "RNA203021",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah K Gruver, FNP
• Bonnie L Hafeman, M.D.
• Shannon I Handler, NP-C
• Megan Lynn Hanenburg
• Bruce Edwin Harvey, MD
• Darin Hoiska, CRNA
• Christina Irwin, LMT
• Dorothy Jean Jamison, MA, ATC
• Charles R Janovsky, CRNA
• Cynthia L Jensen, D.O.

• Certified Registered Nurse Anesthetist in Laurium, MI
• Providers in Laurium, MI by specialty
• Certified Registered Nurse Anesthetist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.